Amir Mohammad Emami

Background Moral distress is a complex and challenging issue in the nursing profession that can negatively affect the nurses’ job satisfaction and retention and the quality of patient care. This study focused on describing the resources and constraints, consequences, and interventions of moral distress in nurses. Methods In a literature review, an extensive electronic search was conducted in databases including PubMed, ISI, Scopus as well as Google Scholar search engine using the keywords including “moral distress” and “nurses” to identify resources, constraints, consequences, and interventions about moral distress in nurses, from the earliest records up to 26 December 2020. The required data were extracted from 61 relevant studies by two independent reviewers. Results Resources and constraints in the occurrence of moral distress among nurses can be divided into three general categories including internal factors, clinical factors, and external factors. The consequences of moral distress on nurses and the medical system reduced moral sensitivity, development of psychological and physical health problems, and the intention to leave the profession. The potential effective interventions were the implementation of integrated communication programs, strengthening physician–nurse collaboration, nursing involvement in clinical decision-making and end-of-life issues, social support, using a resiliency bundle, interdisciplinary discussion, and promoting nurses’ ethical and communication skills. Conclusion There are a wide range of resources and constraints impacting moral distress in nurses that could lead to negative consequences. Further studies are necessary to identify, evaluate, and implement a range of potential effective interventions for the management of moral distress in nurses.

Suppose you are in a situation where you are morally obligated to tell the truth, but choose to say something that is opposed to your beliefs. Later on, it turns out that what you said was true, unbeknownst to you. We might say that you attempted to lie, but failed. Morally speaking, is your situation like that of someone who expressed a true belief with the intention to be honest? Or like someone who intentionally and successfully uttered a falsehood? Such cases illustrate the relation between knowledge, morality, and luck. The problem is a familiar one. Linda Zagzebski (1994) has sought to show that there are certain aspects of Christian theology, namely the traditional doctrines of grace and eternal reward or punishment in the afterlife, that magnify the problem of moral luck. She calls this revised version of the problem “religious luck.” Taking inspiration from this idea, in the following we will explore how religious luck figured in a debate within Islamic jurisprudence concerning the concept of tajarrī. After reviewing contemporary discussions of moral and religious luck, we will introduce the notion of tajarrī in the jurisprudential context, and finally show how moral luck was dealt with in the Islamic legal tradition.